Hypnotism can curb chronic pain, University of Washington study finds

University of Washington researchers think they might be able to use hypnosis to offset pain for patients with spinal cord injuries.

The study is not looking at the type of stage hypnotism one might find in a movie, but a form of intense relaxation and therapy that might ease the burden of those with chronic pain.

“It’s about people learning how to make their mind receptive, and then once our mind is more open to suggestion, we give ourselves suggestions that are helpful,” said UW researcher Elena Mendoza.

No one can force someone to do something they wouldn’t do, she said. Clinical hypnotism is more akin to meditation than anything found in pop culture.

“All hypnosis is self-hypnosis,” she said.

Despite its cultural baggage, hypnosis is a treatment for some conditions. A 2015 position statement of the American Psychological Association endorsed the use of clinical hypnotic cognitive therapy if performed by psychiatrists and with “evidence-based hypnosis practice.”

The research published last week focuses on how hypnosis cognitive therapy might be able to curb the pain of those with spinal cord injuries. Hypnotic suggestion will not do much in the immediate aftermath of an injury, but as one recovers, a lot of chronic pain is produced by the brain rather than the injury itself.

“Often the tissue can be healed, but the brain is still on high alert,” said researcher Charles Bombardier. “And so chronic pain can cause catastrophizing in a patient that ultimately just makes you perceive more pain.”

Fear that chronic pain will never go away or that the patient has no control over their pain can exacerbate symptoms. The UW researchers hypothesized hypnotic suggestion could allow the brain to more readily accept positive messaging about pain and then lower the overall perception of chronic pain.

“Patients have these really strong thoughts about pain that are somewhat maladaptive, and it can trigger more pain and worry and stress,” Bombardier said. “That is what we’re trying to curb.”

Each week, study participants would have a group therapeutic session with Mendoza and then were asked to listen back to a recording of the session three times a day. In these sessions, participants would be asked to relax, breathe deeply and then imagine going to a place where they feel comfortable. While in this highly relaxed state, helpful suggestions about pain management were given.

“When you have those suggestions in that state, they’re going to come to them automatically whenever they need them, and they’re going to experience a lot of benefits from remembering and focusing on those thoughts, focusing on their well-being, focusing on being more confident that they can manage things and that they’ll feel better overall,” Bombardier said.

Throughout the six weeks of these sessions and the six weeks following them, the 127 participants would rate their pain on a scale out of 10.

After six weeks of hypnotic therapy, study participants’ perception of their own pain decreased by 19.3%. Self-reported pain continued to drop when the hypnotic sessions ended. Twelve weeks after the end of the study, their pain had dropped by 24.5%.

Both metrics were much more substantial compared to the control group. Depression severity also declined significantly more in the hypnotic cognitive therapy group versus the control group. Sleep disturbance also declined significantly more with hypnotic cognitive therapy compared to the control group.

“Not only did the study show that this treatment is effective, but unlike most medications used for pain, it is a treatment with many positive side effects, like improved sleep and a greater sense of self-control,” said senior author and rehabilitation medicine professor Mark P. Jensen. “I think that, based on the evidence, including the side-effect profile, this is the first treatment that people with chronic pain should be offered.”

A common treatment for chronic pain are opioids, which carry many side effects and the risk of addiction. Mendoza hopes hypnotic treatment can be a less risky alternative.

“We really want to give people ways to manage their pain that are nonopioids. We hope this research is a step toward that,” he said.

While stressing the need for a licensed medical professional to be the provider of hypnotic cognitive therapy, Mendoza also hopes the technique can be used for all kinds of chronic pain relief.

“You’re not going to do anything against your will. Hypnosis is not about what you see on the movies. It is a clinical, therapeutic technique. We use it every day in a clinical context, and it’s working well,” she said.